BA Ritgerð Pride, Prejudice and the Sperm
BA ritgerð
BA-gráða í mannfræði
Pride, prejudice and the sperm How sperm donors & infertile men perceive themselves
Ágústa Hrönn Hjartardóttir
Leiðbeinandi: Helga Þórey Björnsdóttir Útskriftarmánuður: febrúar, 2018
Pride, prejudice and the sperm How sperm donors & infertile men percieve themselves
Ágústa Hrönn Hjartardóttir
Lokaverkefni til BA–gráðu í mannfræði Leiðbeinandi: Helga Þórey Björnsdóttir 12 einingar
Félags– og mannvísindadeild Félagsvísindasvið Háskóla Íslands febrúar, 2018
Pride, prejudice and the sperm
Ritgerð þessi er lokaverkefni til BA gráðu í mannfræði og er óheimilt að afrita ritgerðina á nokkurn hátt nema með leyfi rétthafa. © Ágústa Hrönn Hjartardóttir, 2018
Prentun: Háskólaprent Reykjavík, Ísland, 2018
Útdráttur
Í þessari ritgerð er sjónum beint að sæðisgjöf, ófrjósemi karla og hugmyndum um karlmennsku í þeim tilgangi að varpa ljósi á tengsl þessara þátta. Spurt er hvers vegna sumir karlmenn gerast sæðisgjafar og hvernig slíkt tengist hugmyndum um karlmennsku. Athyglinni er beint að þessum tveim hópum karlmanna, annars vegar sæðisgjafa og hins vegar ófrjósamra karlmanna, og stuðst er við mannfræðilegar kenningar og nálganir á kyni og kyngervi, til að mynda er umfjöllun R. W. Connell og fleiri um stigveldi karlmennskunar kynnt sem og hugmyndir Paul McIlvenny um hinn heilbrigða karlmannslíkama. Sæðisgjöf karla er skoðuð frá ýmsum hliðum, til dæmis hvernig sæðisgjafar staðsetja sig ofarlega í stigveldi karlmennsku sem og hvernig orðræða um sæði tekur, alla jafna, á sig stereótýpískar myndir. Sjónum er jafnframt beint að ófrjósemi karla og þá sérstaklega hvernig ófrjóir karlar eiga það til að upplifa sig sem ,,minni karlmenn’’ en einnig hvernig gjarnan er litið á ófrjósemi sem ,,misheppnaða karlmennsku’’. Niðurstöður umfjöllunarinnar gefa til kynna mikinn mun á upplifunum þessara tveggja hópa karla á kyngervi sínu og að ástæður fyrir því sé mögulega sökum brennimerkingar og orðræðu en einnig vegna samfélagslegra hugmynda um karlmennsku.
3 Abstract
In this thesis, sperm donation and male infertility are examined from an anthropological perspective. The purpose of the thesis is to shine light on the different ways men perceive themselves, being either sperm donors or infertile. By doing so, anthropological theories and concepts are introduced and used as a basis for the subject. Theories such as R. W. Connell’s concept of hegemonic masculinity, Paul McIlvenny’s concept of the healthy male body as well as anthropological concepts and theories on gender are explored and used throughout the thesis. Furthermore, sperm donation and the discourse on sperm is examined from different viewpoints ranging from how sperm donors perceive themselves to how stereotypical ideas of the sperm are presented in the scientific world. Similarly, male infertility is explored. Especially how infertility in men is often seen as a failed masculinity as well as how infertile men describe themselves as being ‘‘less men’’ than others due to their health problem. The results indicate that there is a big difference in how sperm donors perceive their masculine identity vs. how infertile men perceive theirs and that it is possible that this difference is due to stigma and discourse as well as societies ideas of masculinity.
4 Formáli
Ritgerð þessi er lokaverkefni til BA-gráðu við mannfræðideild Háskóla Íslands. Vægi ritgerðar er 12 einingar (ECTS) af 180 eininga námi í mannfræði og er skrifuð á haustönn 2017 fyrir brautskráningu vorið 2018. Leiðbeinandi í lokaverkefninu var Helga Þórey Björnsdóttir og vil ég þakka henni kærlega fyrir einstaklega góða leiðsögn og fyrir að hvetja mig áfram í skrifunum. Ég vil einnig þakka systur minni, Fanný Heiðu Hjartardóttur, fyrir alla hjálpina og vinkonu minni, Rakel Guðmundsdóttur fyrir ómetanlegan stuðning. Að lokum vil ég þakka foreldrum mínum fyrir að vera alltaf til staðar fyrir mig.
5
Table of contents
Útdráttur ...... 3 Abstract ...... 4 Formáli ...... 5 Table of contents ...... 6 Introduction ...... 7 1 Gender theory in anthropology ...... 10 1.1 Anthropology and masculinities ...... 13 1.1.1 Hegemonic masculinities ...... 16 1.1.2 The male body ...... 18
2 Sperm donation ...... 22 2.1 The sperm ...... 24 2.2 Becoming a sperm donor ...... 27 2.3 Masculinity and sperm donors ...... 28 2.4 The Viking sperm ...... 29
3 Male infertility ...... 32 3.1 Medicalization and male infertility ...... 32 3.2 Infertility and lack of masculinity ...... 33
4 Discussions ...... 38 5 Conclusions ...... 40 References ...... 42
6 Introduction My interest in the subject of sperm donation first began when a group of my male friends decided to go to a sperm bank to donate sperm in Denmark. They informed me about their experiences and that one of them found out that his sperm count was low. He was therefore not qualified to be a sperm donor. It seemed as if he felt quite ashamed over the incident and was embarrassed to speak about this discovery. On the other hand, the ones who were qualified seemed quite proud and were open to discuss this experience and the results of their sperm count test. This event made me think about sperm donation, the idea and meaning of sperm and how it relates to masculinity. I started speculating if sperm and masculinity are linked phenomenon’s in society and if so, how are they linked together. The goal of this thesis is therefore to try and shine light on the reasons for why men become sperm donors and how it relates to masculinity. This topic has not been a focus point for anthropologist until the last few years when the amount of both sperm donation and donor insemination increased (cited in Mohr, 2014, p. 162). That seemed to have sparked an interest for anthropologists to study male infertility, which had not been previously done. The main theories applied in the anthropological work written on masculinity are the theories of hegemonic masculinity, the male body and the discourse on sperm in today’s society. These theories will be further studied in this thesis by looking into how commercials and advertisements are directed at sperm donors and sperm donation receivers. As well as to study how being an infertile man can alter way men perceive themselves versus how sperm donors perceive themselves. I will be demonstrating this by looking into anthropological work written on masculinity and using theories of hegemonic masculinity, the male body and the discourse on sperm in our society. By for example looking into how commercials and advertisements are directed at sperm donors and sperm donation receivers. Furthermore I will look at how being an infertile man can alter the way men perceive themselves versus how sperm donors perceive themselves.
7 The first chapter of this thesis presents the history of anthropology and gender theory, the theory of hegemonic masculinity as well as theories on the male body. The aim of this chapter is to shine light on the anthropological research done on men and masculinity in a historical context and looking at what aspects anthropologists focused on when studying men. I introduce the concept of hegemonic masculinity formed by R. W. Connell and explain briefly the main concepts of the theory. I use the theory throughout the thesis as the main support to the material of sperm donation as well as male infertility. The first chapter then concludes with an introduction to anthropological research on the male body and how there have been different focus points on studying the male body, all from being on aesthetics of the male body towards a more recent sexualization of the male body.
Chapter two is dedicated to the sperm. In this chapter the sperm is presented from an anthropological view. To begin with I introduce anthropological research done on sperm donation, sperm banks and sperm donors. There haven’t been many anthropologist that have specifically focused on these matters (Mohr, 2014) and therefore it is important to look at the few researches that have been made in order to explore the main focus in those researches. In chapter two a overview is presented on sperm donation and masculinity. Here I mainly support the material using ethnographic work by anthropologist Sebastian Mohr (Mohr, 2014). Mohr’s work shines light on how sperm donors place themselves higher on the hegemonic masculinity. This can be seen clearly in the way sperm donors perceive themselves and their masculinity through their sperm quality. It is important to look at why sperm is linked to masculinity and therefore I discuss how there has been a specific discourse on sperm in both the media as well as in the medical world. This discourse can influence the way sperm is perceived in society as well as influence the way sperm donors and infertile men perceive themselves (Martin, 1991)
From there on chapter three consists of research and theories on male infertility. In this chapter I go over some main issues and problems that both men with infertility experience as well as the consequences of male infertility and the stigmatization of this health issue in society today (Tjørnhøj-Thomsen, 2005). I look at how male infertility has been medicalized in the past few decades and what that has entailed for this health
8 problem. Looking at male infertility one can see how it links to notions of masculinity and that can be useful when understanding both the stigma around infertility as well as the common misconceptions people have about male infertility (Bell, 2016). I conclude the thesis by connecting the theories and researches introduced in the thesis to the idea of sperm donors having a leading position on the hierarchy of hegemonic masculinities in contrast to men who are infertile. I believe that once I have covered the aforementioned chapters I will be able to bring forward a well-founded conclusion into the subject of sperm donation and masculinity. Specifically if there is a linkage between men feeling a lack of masculinity due to low sperm count. As this is a relatively new research field I believe there is also an opportunity for this subject to be researched further.
9 1 Gender theory in anthropology In this chapter a brief theoretical overview will be presented surrounding how anthropologists have, throughout history, dealt with definitions and concepts of gender and sex. The object of the chapter is to give a wide introduction into the subject in order to provide the reader with an understanding of how gender theory came to be. It is important to look at women’s position throughout history within anthropology and how women have challenged the male dominance in the field. Thereupon can one better understand the theories and concepts of gender and sex that have surfaced within the field of anthropology through time.
From the beginning of anthropological research and onwards, women anthropologists were mostly absent and often excluded. Ruth Behar (1995, p. 5) argues that gendered hierarchy produced power relations within anthropology. Women’s work and their contributions was not recognized by scholars in anthropology which is evident when looking at citations within the field where men are, according to Behar (p. 9), more frequently cited than women especially when it comes to theoretical work. Women’s writings on gender issues and gender roles are cited less frequently and in a circumscribed context according to Behar (p. 9). She further argues that the academy has decided what constitutes as an important anthropological reading and that those writings are ‘coincidentally’ written by white men (Behar, 1995, p. 11)
The social environment in the western world around the 1960s and 1970s sparked women’s awareness surrounding gender inequality, male dominated public sphere and women’s oppression (Moore & Sanders, 1999, p. 16). At that time civil rights movements, student activists surfaced and protests against both social policies as well as the Vietnam War around United States influenced women and that led to the forming of the women’s movement (Mascia-Lees & Black, 2000, p. 6-7). Women of that time focused on inequality, women’s oppression and their social and economical status in society. This influenced many academic fields along with anthropology. As discussed earlier, women were invisible in the academic field and from anthropological writing and anthropology ignored issues of gender (Mascia-Lees & Black, 2000, p. 7). From the influence of the women’s movement the discipline of feminist anthropology arose. Feminist anthropology dealt with gender roles, inequality and comparing systems of
10 gender oppression (p. 9). Feminist anthropologists also approached earlier work by influential women in anthropology such as Ruth Benedict and Margaret Mead and looked at them with fresh eyes uncovering the different ideas these women had on gender and gender roles (Mascia-Lees & Black, 2000, p. 9).
Even though the work of women anthropologists, such as Elsie Clews Parsons and more, before the women’s movement was not valued as theoretical or important work it influenced feminist anthropology greatly, especially theories on the nature/culture concepts as well as the sex/gender system (Behar, 1995, p. 11). Henrietta L. Moore (1994, p. 10-11) discusses how the cross-cultural data that anthropologists had collected on gender and gender role affected feminist theory in the 1970s. She points out that the cross-cultural data provided feminists the content to establish that gender was socially constructed and not biologically determined (Moore, 1994, 11).
Before that, essentialist interpretations on gender prevailed in studies of gender. That meant that gender differences were viewed and presented as completely dichotomous (Cornwall & Lindisfarne, 1994, p.3). As well as these gender differences being stable throughout history. Essentialist ideas of gender mean that ‘being a man’ or ‘being a woman’ was fixed and universal. Cross-cultural data from anthropologists however exposed a diversity of meanings on gender (Cornwall & Lindisfarne, 1994, p. 3).
By drawing attention to the dichotomies of women and men as well as the division of nature/culture, anthropologist Sherry B. Ortner revealed the implications of such dichotomies in her paper Is female to male as nature is to culture? (1972). Ortner (1972) introduced an influential theory on the subordination of women and the dominance of men in her paper. She argues that everywhere in the world, women are subordinate to men and that the reason for the subordination of women is due to the fact that women are considered closer to nature and men to culture. She claims that the subordination of women causes women to be stuck to the private spheres whereas men have access to the public sphere. She discusses how culture is dominant to nature and by connecting women to nature the subordination of women is legitimized. Ortner (1972) gives several reasons for why women are considered closer to nature and mentions for example women’s bodily functions, their domestic positions, their psychic structures
11 and so on. She also discusses how this is only subjective but can be useful to understand this subordination and domination. Ortner (1972) argues that this subordination can be found in the academic world where women are usually kindergarten teachers whereas men are university professors and therefore take over the socializing on a ‘higher’ level (1972, p. 19).
Candace West and Don H. Zimmerman dig further into the ideas of sex and gender in their article Doing Gender (1987). They argue that in the late 1960s, scholars made the distinction between sex and gender. Sex was considered fixed and ascribed by biology; sex had to do with anatomy, hormones and physiology. Gender was however something that was achieved. It was considered to be constructed through cultural and social means (West & Zimmerman, 1987). West and Zimmerman focused on the interactions and relations where gender is reinforced and acted out. They therefore contradicted the popular opinion in western societies that gender consists of either women or men and that these are naturally binary categories. They argue that by doing gender we are creating these differences between women and men and that these differences are not biological or natural but constructed and sustained. Furthermore, West and Zimmerman (1987) stress that gender legitimizes the limits that are maintained on women and men. Gender theorist Judith Betler (1988) goes along similar lines but argues that gender is something that we perform, produce and sustain. Sex is the biological facticity but gender is performative. Betler (1988) argues that when a person fails to perform a gender correctly the person gets punished by society (Butler, 1988, p. 242).
As gender is not biologically given but socially and culturally created it is fluid and diverse. For example transgender people are those who are designed a biological sex category at birth but deny that their gender corresponds with their sex, therefore not identifying their gender with their sex. Along with transgender, there are several different genders such as the third gender, bigender, pangender and genderfluid which all share the common characteristics of not identifying with the dichotomous female/male categories (Connell, 2010).
Along with understanding the difference between sex and gender, feminist anthropology has also focused on studying the concept of gendered identities.
12 Gendered identity is the performance of particular activities, which influences the way we behave ourselves as male or female (Moore, 1994, p. 39). Moore (p. 50) discusses the importance of discourses in constructing individual identity as a gender identity. For example in western cultures the discourse on male sexuality has often been portrayed as aggressive, powerful and thrusting whereas female sexuality is seen as passive, submissive and receptive. Moore (1994, p. 63) argues that women and men can identify with several different masculinities and femininities and that these masculinities and femininities are provided by the dominant discourses on gender. Victor J. Seidler (1989, p. 21) argues that in order to understand this subordination of women and dominance of men in this world we need to look at how men are forced to compete within to gain from this dominance.
Having now shed light on these different gender theories, I believe that it is clear that many anthropologists approach the subject of gender by dividing the genders into for example subordination and dominance, aggressive and passive. This is why there is a need to dive deeper into the subject of anthropology and masculinity as will be done in the next subchapter.
1.1 Anthropology and masculinities Through time anthropology has been considered a field where men study other men (Gutmann, 1997, p. 385). However there wasn’t much attention brought to studying men as a male gender in itself in anthropological research. Matthew C. Gutmann (1997, p. 387) briefly goes over the history of anthropology and masculinity in his article Trafficking in men: the anthropology of masculinity. To begin with most anthropological research on men and masculinity was on ‘exotic’ men in far away cultures with the aim to discover either a different type of masculinity or a ubiquitous masculinity. In the article Gutmann (1997) mentions Anthropologists Malinowski and Evans-Pritchard who both began studying matters surrounding men, manhood and masculinity in these ‘exotic’ cultures. These were matters such as sexual drive, male authority, relationships between men and women and so on (cited in Gutmann, 1997, p. 387). As Anthropology was becoming a field of study there was an increased visibility of both ‘unmanly’ men and ‘unwomanly’ women. This visibility posed challenges to modern masculinity and sexuality. Due to this there was an increased focus on gender, gender differences and
13 sexuality in anthropological research (Gutmann, 1997, p. 388). Gutmann (1997, p. 388) refers to for example Margaret Mead and Ruth Benedict and how they, as anthropologists focused on gender issues at the time. For example Mead focused her studies on sexuality and adolescence and Benedict researched the diversity of masculinities as well as emphasizing on homosexuality.
Around World War II many anthropologists of that time focused their research towards masculinity in wars, rites of passage, comparing similarities and differences between men, male personality and more (Gutmann, 1997, p. 388). There was also a comparison of men and women in terms of character traits. Man-woman dualism was examined and the concept of masculinity and femininity was seen as a biological feature as discussed earlier in the chapter of feminist anthropology (Gutmann, 1997, p. 388- 389). Before the women’s movement, sociologists and anthropologists had already recognized the male sex role. During that time it was increasingly popular to write about the male role and connecting oppressive behavior by men to the role norms (Connell & Messerschmidt, 2005, p. 831).
In the early feminist anthropological studies around 1960 there was the prominent idea that men were men and women were women and that genders were completely dichotomized. This was the standard way of viewing the genders. This meant that women did not play any part in ‘’making’’ men and the same goes with men ‘’making women’’ (Gutmann, 1997, p. 388-389). For example Gutmann (1997, p. 388) points out that Lévi-Strauss, who was incredibly influential in early feminist anthropology, barely mentions men and women in his book Elementary Structures of Kinship. One can see clearly how the dichotomies of genders were already given and the categories, men and women, were fixed and intransigent (cited in Gutmann, 1997, p. 388-389). As mentioned earlier the women’s movement had a great influence on studies in anthropology and feminist anthropology rose to popularity. Women started to focus on women in ethnographies and began describing the world from woman's viewpoint (Mascia-Lees & Black, 2000, p. 9). Anthropologists of that time began asking basic questions on for example the relationships between men and women as well as moving away from the dichotomies associated with gender being divided into either man or woman. Women studies did not only concern women but also questions surrounding
14 men, power, masculinities and so on (Cornwall & Lindisfarne, 1994, p. 28-29). It was then during the late 1980’s and early 1990’s when anthropologists started addressing and discussing manliness and masculinity/ies as an important field of study (Gutmann, 1997, p. 388-389).
Anthropologists have emphasized in their research the fact that in all societies in the world there is a division of the genders, however the idea of masculinity and femininity does not exist everywhere (Connell, 1995, p.67). Masculinity and femininity are phenomenon’s that are both cultural and societal and there are different understandings of these concepts. When looking at masculinity from a western point of view, one can see that masculinity often reflects a kind of behaviour that is branded as ‘masculine’ (Connell, 1995, p. 67-68). Victor J. Seidler (1989, p. 18) argued that this masculine behavior is something that men no longer notice, as it has become a deeply rooted part of men’s identity. Seidler believes that men try so hard to live up to the dominant images of masculinity that they have lost their sense of self. These dominant male images indicate that men should hide their emotions, be strong and in control. This entails men identifying only to their masculinity rather than their sense of self.
What is evident is that masculine behavior doesn’t exist without the comparison of feminine behavior. Raewyn Connell (1995, p. 67-68) argues that to understand what masculinity is, it is important to stop looking at masculinity as a thing or an object and start focusing on the processes that men perform as well as the communications that men are involved in, the power relations between men and the dominant ideas of masculinity. Therefore Connell (1995) enunciates that masculinity are the practices that men perform and these practices influence men’s personalities, culture and bodily experience (Connell, 1995, p. 71).
Anthropologists Andrea Cornwall and Nancy Lindisfarne (1994) define masculinity in four ways. According to them masculinity and maleness is defined by being opposite to female and feminine. This is a similar idea to what Connell (1995) says on masculine behavior as discussed above. Second, Cornwall and Lindisfarne (1994) argue that gendered identities rely on obtaining socially appropriate characteristics. Thirdly, ‘normal’ sexual orientation is heterosexual due to the merging of learned behavior, desire and biological attributes. Lastly, the idea of masculinity is universalized through
15 sexual, social and biological suggestions (Cornwall & Lindisfarne, 1994, p. 11-12). Although several theories in the subject of masculinity have now been discussed, one theory stands above others, which is the theory of hegemonic masculinity. Due to its important influences a separate chapter is needed to discuss the theory in depth.
1.1.1 Hegemonic masculinities As mentioned earlier one of the most influential theories in the study of gender is the theory of hegemonic masculinity that was first put forward by Tim Carrigan, Bob Connell, and John Lee (1985). Their aim was to bring a framework into science that would replace the sex role framework that prevailed the studies of masculinity at that time. In their opinion the sex role framework, ‘’is an abstract view of the differences between the sexes and their situations, not a concrete one of the relations between them.’’ (p. 580). Their argument was that there is not just a division of men and women, there is also a division between men. That is to say that there is a hegemonic masculinity and then different types of subordinated masculinities. They suggest that power relations differentiate masculinities as well as their interplay with division of labor and emotional attachment (Carrigan et al., p. 591). The concept of hegemonic masculinity was then further developed by R.W. Connell as a part of her gender theory. Connell refers to masculinities as a plural concept. The reason for that is that masculinity can be divided into multiple masculinities for example masculinity of white men, gay men, middle-class men and so on. These masculinities all differ from each other. She argues that it is not enough to acknowledge these different types of masculinities but that scholars have to dive deeper into the relations between these masculinities. Connell (1995) claims that ‘‘hegemonic masculinity can be defined as the configuration of gender practice, which embodies the currently accepted answer to the problem of legitimacy of patriarchy, which guarantees the dominant position of men and subordination of women’’ (p. 76). Meaning that hegemonic masculinity legitimizes the dominant position held by men in society and the subordinate position held by women (1995, p. 77). Connell argues that hegemonic masculinities can however be mobile. Masculinities change when new groups challenge the former dominant masculinities. They come to existence at certain places and times and can therefore change (p. 87). Hegemonic masculinities always
16 entail the fact that women are subordinate to men. Yet, few men actually meet the standards of normative masculinity but despite that the majority of men gain from this hegemony due to the dominance they have over women.
It is important to look at the connections between different types of masculinities since they can reveal alliances, dominance as well as subordination (1995, p. 78). Connell (1995, p. 143) discusses how for example homosexual men are at the bottom of hegemonic masculinity due to the fact that gayness can be related to femininity. Gay men are often considered to lack masculinity and this results in them being subordinate to other hegemonic masculinities. The concept of hegemonic masculinity received criticism from sociologists and anthropologists for different reasons. For example sociologist Alan Petersen (2003) pointed out that the even though the concept of hegemonic masculinity states that there are power relations between both men and men and women, the theory hasn’t been used to reveal these power relations. Instead the theory has entailed that masculinities have now only represented diversity and/or plurality (Petersen, 2003, p. 57). The theory has also received criticism for being unclear on matters such as what type of men actually represent hegemonic masculinity and that the theory refers to a fixed type of masculinity (Connell & Messerschmidt, 2005). The concept of hegemonic masculinity was further developed by Connell and Messerschmidt (2005) after the theory received criticism for being outdated as well as the concept had been used in different contexts resulting in an ambiguity as to the true meaning of the concept. This was something that had not been foreseen by earlier scholars. Connell and Messerschmidt (2005) therefore saw an opportunity and a need to clarify the concept which was their main focus point in their paper Hegemonic Masculinities: Rethinking the Concept (2005). In the paper they came up with four main areas where the theory needs to be rethought. These areas are: the nature of gender hierarchy, the geography of masculine configurations, the process of social embodiment and the dynamics of masculinities (Connell & Messerschmidt, 2005, p. 847). To begin with the concept needs to incorporate a better understanding of the gender hierarchy, that is to look into subordinated groups as well as dominant groups and dynamics between these groups (2005, p. 848). Secondly, it is important to distinguish between local, regional and global masculinities and see the interplay of society and how it
17 affects these masculinities (2005, p. 850). Thirdly, looking at the processes of social embodiment entails that men use their bodies to represent a particular masculinity and a certain social construction and therefore it is important to relate it to hegemonic masculinity (2005, p. 851). Lastly, the dynamics of masculinity signifies that masculinities are constructed and unfolded and they change through time. Hegemonic masculinities are therefore dynamic as they are likely to involve ‘’specific patterns of internal divisions and emotional conflict’’ according to Connell and Messerschmidt (p. 852).
Since the concept of hegemonic masculinity was formed it has been used in several academic fields such as social science, anthropology, education studies, criminology, media studies and more. As Connell and Messerschmidt argue (2005), applying the theory on these fields has helped make sense of variable matters involving masculinities. Understanding of the hierarchy between men has for example been useful when studying health and illness in men, especially when it comes to the difficulties men face when responding and discussing health, illness and disability (p. 834) As mentioned above, hegemonic masculinity results in both hierarchy between men and women as well as between men and men. For example men are subordinate to other men due to race, social class, ethnicity, sexual orientation and so on. There is also the group of men with physical disabilities and physical limitations that do not get access to the dominant masculinity. Men with physical disabilities or limitations often get stigmatized and marginalized in society due to reasons such as not being able to live up to the normalized standards of the male body and the typical role of the body (Gerschick & Miller, 1997, p. 456). It is apparent that men’s bodies play a large role in masculinity and how they view their own masculinity. It is therefore important to look even deeper into the meaning of the male body as will be done in the next chapter.
1.1.2 The male body The body is an indispensable part of our everyday lives and mediates all action in the world. The body has not always been a subject in anthropological research but anthropologists have however paid a great deal more to the challenges posed by the body than other social scientists have. Although Margaret Lock (1993) argues that there
18 has been an uneven focus on the body in anthropology and its appearance in anthropological research has been sporadic throughout the years. This view is further supported by anthropologist Thomas J. Csordas (1999) who wrote that, throughout history, anthropologists have written ethnographies on different matters surrounding the body. Anthropologists have for example focused on subjects involving the body such as decorations, tattoos and other bodily aesthetics. He traces the history of the body in anthropological research and divides it into four waves. To begin with the body wasn’t a prominent subject when studying social science. It wasn’t until 1960s when the body became more of an isolated subject. Later on the body became a problematic subject in anthropology due to its cultural and societal variability, that is to say that scholars were starting to contemplate the difference between the body and mind, the biological and the cultural, which created this problematic situation of the body. Lastly, the body was seen as an opportunity to reconsider the many different sides of culture and the self, namely that we have different embodiments, and when looking at how these embodiments are formed one can understand the culture that affects it (Csordas, 1999).
Anthropologists Nancy Scheper-Hughes and Margaret M. Lock (1987) critically discuss the usage of the body within anthropological studies and propose another understanding of the body. Scheper-Hughes and Lock (1987) divide the body in three levels. They argue that the first level is the individual body. That is how everyone experiences their embodied self. The second level is the social body. The social body is the usage of the body to understand society and according to Scheper-Hughes and Lock the usage of body is good to think with in relation to nature, culture and society. The third and last level is the body politic. This refers to the surveillance and regulation that the body goes through. For example in western societies the politically ‘correct’ body is the healthy, strong, beautiful body. They argue that it is important to look into the body to understand culture and society (Scheper-Hughes & Lock, 1987, p. 7-8).
When examining the male body specifically, one can see how there have mostly been two main conceptions of the male body (Connell, 1995, p. 45). One is more towards the biological role of the male body. That is to say that the body produces gender difference, which is done through both hormonal difference as well as the difference of the sexes in reproduction. The other concept of the body has been
19 common in social science and that is that the body is a neutral phenomenon and that social symbols imprint themselves onto the body (Connell, 1995, p. 45-46).
Thomas Johanson (2008) claims that in recent years, the body has been increasingly sexualized. This refers to both the bodies of men and women. The body has been seen as a sexual object and certain body parts have received more attention than others. Johanson discusses how demands on these body parts are becoming almost impracticable and that the consequences of these demands could be fateful. This sexualization of the male body is a relatively new development according to Johanson (2008). This brings about young men looking judgmentally at their own body as well as other men’s bodies. It also encourages men to strive somewhat for perfection and that can create a new image of the masculine body. Johanson (2008) contemplates how the exposure of men’s bodies in media and advertisements has contributed to this sexualization of the male body. He argues that the bodies of men as well as men’s sexualities are often scrutinized and criticized from a woman's viewpoint. They are seen as uncontrollable, their sexual appetite is insatiable and they are potent and even sexually threatening. (Johanson, 2008, p. 16-18). Johansen also argues how this potency is a central aspect in forming masculinity today. Being an impotent man is seen as being a man that does not have control and is not successful and that can lead to a fragile identity and confidence (Johansen, 2008, p. 19).
It seems as if the body is becoming constantly more visible in our everyday lives and more highly valued. Today it is expected of people to take care of their bodies and lead healthy lifestyles. The body is in a way disconnected from the mind and becomes a separate object that needs to be taken care of. Seidler (2003, p. 87) claims that men have, throughout time, been encouraged to see their bodies as an instrument or a machine. In this context the body needs to be healthy to operate accordingly and if the body becomes ill or weak men feel disappointed and annoyed. Men have for this reason seen their body as something that receives orders or is instructed to be a certain way and that can make it difficult for men to understand the emotional life of the body (Seidler, 2003, p. 87).
Similarly Paul McIlvenny (2003) discusses how patriarchal societies in the west have always made the connection of being a man is being healthy, strong and able and how
20 being able is having a ‘normal’ body. McIlvenny (2003) argues that there is a need for more research on how the hegemonic notions of masculinity interact with notions of disability (McIlvenny, 2003, p. 238). The body and the self are connected and what happens to either affect the other. People often describe illness or disability as something that is happening to ‘them’ and not their ‘body’. Juliet M. Corbin (2003) claims that people know and trust their body when it is healthy. However when in illness, the body often becomes unfamiliar and people feel like they don’t understand or know their body any longer. The body gives out information to the self and when there is illness, these information’s can be difficult to receive and interpret. Corbin (2003) discusses how people with illness construct their illness identity and that often has to do with the fact that they feel loss of control over their body or that the body can no longer do what it use to or is suppose to do.
In the chapters above a theoretical overview has been presented surrounding how anthropologists have dealt with definitions and concepts of gender and sex as well as looking at ideas on masculinity and the male body within anthropology. These chapters have been crucial in order to understand the following chapters on sperm donation as well as male infertility. That is due to the fact that anthropological research on both sperm donation and male infertility, theories such as hegemonic masculinity, theories on the male body and male role are presented. As the purpose of this thesis is to explore masculinity in connections to sperm, the next chapter will cover various aspects of the concept of sperm donation.
21 2 Sperm donation In this chapter sperm donation will be discussed as well as looking at main anthropological research done on sperm donation. To begin with I will however briefly introduce controversies and laws regarding sperm donation. The first reported case of donor insemination was 1909. A man provided semen for an infertile couple and did not receive payment, therefore it was called sperm donation (Daniels, 2000, p. 206). Since then sperm donation and donor insemination has been considered a controversial reproductive technology (Daniels, 2000, p. 209). The controversy mainly regards the consequences of sperm donation for example if the offspring should be able to seek contact or not, as well as the controversy of selling gametes and the payments sperm donors receive. There have been heated debates about sperm donation through the decades (cited in Daniels, 2000, p. 209-210). Some believe that the selling and buying of gametes is a threat to what is valued about families. There have also been discussions surrounding people seeing gametes as properties and as seeing gametes as components of personhood. The idea that children who are conceived with donor insemination owe their existence to a commercial transaction has also created controversy due to the fact that sperm donors get paid for the act (Daniels, 2000).
There are many different ethical perspectives towards sperm donation and countries have different legislations and policies surrounding this reproductive technology. Throughout history different laws and regulations have been made surrounding sperm banks and sperm donations. Today it is however legal in countries around the world. One of the largest sperm banks in the world is located in Denmark and at one point the country was a world leader in the use of fertility treatments (Adrian, 2010).
Since sperm donation and donor insemination has grown in popularity there has been an increased popularity of researching different aspects of sperm donation (Mohr, 2014). For example scholars from diverse fields such as gynecology, psychology, sociology and anthropology, have tried to find out why men donate their sperm and what it means to be a sperm donor (cited in Mohr, 2014, p. 162). Research that involves
22 sperm donation and masculinities mostly trace back to the 1980s. In these studies there was a wide range of issues that researches focused on such as anonymity in sperm donations, kinship ties, compensation and family (Mohr, 2014).
As sperm banks and donor insemination is a well-known phenomena in Denmark there have been several researches done on this subject in Denmark. Danish researchers Stine W. Adrian and Sebastian Mohr have both done ethnographic work inside the sperm banks, on sperm donors and ethics. Adrian (2010) did her research mostly inside the sperm banks in Denmark and Sweden and analyzed the environment of these different facilities. She has also looked at how the families that choose donor insemination as well as the sperm donors are stigmatized and marginalized within these sperm banks (Adrian, 2010). Mohr (2014) focused his research mainly on the sperm donor’s narratives and their motivations. Mohr (2014) has used qualitative research to understand the real reasons why men donate their sperm as he argues that sperm donors embody their masculinity through this practice. He also looks at masturbation and sexual practices in relation to sperm donation, a subject that has never really been asked about or discussed in former researches on sperm donors.
On the other hand, Medical anthropologist Marcia C. Inhorn (2004) focused her studies on masculinities, sperm donors and male infertility in the Middle East. Inhorn (2004) has been very influential in this field of medical anthropology. She has examined for example stigma in relation to male infertility and how it is a problematic health problem for men especially in the Middle East due to the patrilineal structures in those societies. Inhorn (2004) has also done research on the social impact of male infertility (Inhorn, 2004).
Conversely, Anthropologist Ken R. Daniels (2000) discussed a different angle in his research, focusing on anonymity of sperm donations as well as the ethical viewpoint of reproductive techniques. Furthermore he has examined the ideas of giving and selling gametes and the effects and consequences of giving such ‘’gifts’’ (Daniels, 2000). In recent anthropological research on this field of study there has been a direction towards studying the donor's actual experiences of donating sperm. Such as looking at the motives, reasons and attitudes sperm donors have towards donating their gametes. As well as examining donors narratives and providing insight into the their experience of
23 the donor process (Van Den Broeck, Vandermeeren, Vanderschueren, Enzlin, Demyttenaere & D’Hooghe, 2013).
It seems as if sperm donation has many different ethical and controversial aspects to it. Due to the complex aspects that come with donating sperm the next chapter will exclusively research the sperm.
2.1 The sperm Looking at the discourse on sperm in the scientific and social world one can see that there have been several different representations on the sperm. Kenneth Gannon, Lesley Glover and Paul Abel (2004) carried out a discourse analysis on some of the largest newspapers in Britain to see how male infertility and masculinity was represented in media. They examine how sperm and infertility is presented in media and how those representations can tribute to stigmatizing infertility in men. Gannon et al. (2004) identified a few main discourses in the media concerning infertility. First of all the crisis of infertility was the dominant of these discourses. In this discourse newspapers discussed how human fertility was dropping rapidly and that the infertility rates were getting higher and higher. In this discourse it was described how there are fewer and fewer men being capable of normal sperm production. These accounts of infertility crisis were often described using masculine language and descriptions. For example the testicles were compared to machines or cars that were producing sperms with turbo speed and so on. Sperm count in men was also very often compared to other animals such as for example that men today are producing less sperm than hamsters and how men’s performance concerning fertility is falling behind other animals (Gannon et al., 2004).
Another discourse on sperm count in the media was describing the amount of sperm as a mysterious thing. That is to say that even constituting what is considered a normal amount of sperm was a problematic and a mysterious thing that no one has answers to. The decline in sperm count, which has occurred in recent years, was also considered mysterious and the reasons for this decline unexplainable (Gannon et al., 2004). The decline in sperm count was described as a threat to mankind and masculinity. The final discourse that the researchers identified on sperm count in the media was using language connected to war and assault. For example some described
24 the low sperm count today was due to ‘assault on male reproductive organs’. Sperm count in the context of war and assault is being represented as a soldier waging a war and losing that war is losing manhood (Gannon et al., 2004).
It was discovered that when it came to describing and discussing sperm and sperm count, the newspapers would in general use stereotypical masculine references. This can result in infertility and low sperm count being stigmatized by media discourse as well as influence the way men see their health and their relationship with their bodies. Researchers argued that the language used in the media concerning low sperm count often implied that masculinity was being threatened (Gannon et al., 2004).
Anthropologist Emily Martin (1991) discusses how sperm has been personalized and medicalized in the scientific world in her paper The Egg and the Sperm: How Science Has Constructed a Romance Based on Stereotypical Male-Female Roles. She argues that in scientific texts the sperm is often described as strong and powerful and has fuel or power to deliver the genes to the egg. The sperm’s behavior is described in a masculine way while the eggs behavior is described in a feminine way and therefore given a gendered stereotypical aspect. The act of a sperm delivering genes to an egg is often described as the sperm being a winner, being successful or a survivor. Martin (1991) further argues how the sperm is considered independent and how it operates in isolation to reach its goal. The sperm cells take on a long journey where some fall behind while the winners ‘’assault’’ or ‘’attack’’ the egg. Martin (1991) discusses how in biology textbooks the egg is even made to seem as a ‘’damsel in distress, shielded only by her sacred garments; sperm as heroic warrior to the rescue’’. (p. 491). This reveals the incredibly stereotypical ideas of the sperm and the egg in the scientific world and that further reinforces the gendered hierarchy into the social world through these representations of sex cells (Martin, 1991, p. 500).
In a research carried out by Wolfgang Wagner, Fran Elejabarrieta and Ingrid Lahnsteiner (1995) focusing on objectification and metaphors on sperm and ovum, the results showed that people tend to see sperm as being stronger, harder and active while ovum is seen as passive and weaker. It seems as if people tend to use stereotypical ideas of men and women roles and project them on sperm and ovum. Sperm and ovum was compared to sexual and social life where men are seen as more
25 active and women more passive or submissive. Using metaphors to better understand the process of fertilization does not however mean that they reflect truth of fertilization but that they are simply ‘good to think with’ (Wagner, Elejabarrieta & Lahnsteiner, 1995, p. 5). Metaphors in the medical world are a common way to conceptualize the situations or the circumstances. One metaphor in a medical discourse that is quite common is the WAR metaphor when discussing processes that happen in the body. An example of this is that cancer patients are often described as ’battling’’ cancer or that a tumor is ‘invading’ the body. Very often the patient is described as a warrior and that the cancer is the enemy. Using metaphors when dealing with illness can change the way the illness is viewed and help people conceptualize it (Dragusin, 2014). As Martin’s (1991) examples of how sperm and eggs are often described, one can find similar types of metaphors. For example comparing the sperm to a warrior, winner or a hero and the egg as something that needs to be ‘’assaulted’’. Metaphors have a purpose in the scientific discourse or as Dragusin (2014) phrases it:
Metaphors are not an accidental presence in medical scientific texts; on the contrary they have a crucial role within the discursive strategies. The medical metaphor has the power to modify the perception of certain events, to orient the scientific theory towards a certain direction, to offer a key to reality interpretation. (p. 1233).
Therefore it is important to see how for example sperm cells and egg cells are portrayed in the scientific or medical world. Especially seeing how they are often linked to metaphors of war. Dragusin (2014, p. 1224) argues that by using metaphors of war, the discourse is masculinized since war can be considered a masculine activity. By presenting the discourses and metaphors on sperms and eggs used in both the media and the scientific world it shines light on how these cells are being gendered and given stereotypical gender roles. One can see how this masculinization of sperm cells could affect sperm donors and how they perceive themselves. Therefore the next chapters will focus solely on sperm donors and masculinity.
26 2.2 Becoming a sperm donor Before 1997 Denmark already had one of the largest sperm donation bank in the world. In 1997 a law was passed in Denmark that was intended to prohibit doctors from performing sperm donation on specific groups of people (Adrian, 2010, p. 396). These were mostly homosexual couples and single women. However since the law only stated that doctors weren’t allowed to do it, a midwife set up a private clinic herself and ironically Denmark became a country where access to sperm donation was easy for these groups of people. In 2007 Denmark lifted the ban and since then single women, heterosexual and homosexual couples can legally get access to sperm donation performed by doctors in Denmark (cited in Adrian, 2010, p. 396). In Denmark, sperm insemination is performed by both private clinics as well as the public healthcare system. In 2002, Denmark was the world leader in the number of children conceived by using some type of fertility treatment. There is therefore an especially widespread use of reproductive technologies in Denmark (Adrian, 2010, p. 395).
Sperm donation is a rather simple and easy process for men to go through. A man must be in relatively good health to be a sperm donor and be between the ages of 18 to 40. However there are some limits to that who can donate sperm. For example men, who are adopted, have genetic diseases or homosexual men cannot become sperm donors in Denmark (European Sperm Bank, 2017a). If a man wants to become a sperm donor he has to hand in a sperm sample and get a health check done. The sperm coordinator looks into the man's family’s medical history and if everything turns out to be alright then a profile is created for the sperm donor and he becomes a qualified sperm donor. It is usually expected for donors to donate sperm at least 4 times a month and to be a donor for at least a year. Men can donate their sperm every 48 hours after their last ejaculation. Sperm donations are paid for and in Denmark this varies a little by the sperm bank but it the amount of money varies from sperm bank to sperm bank. A sperm donor can decide if he wants to be an anonymous or open donor. An anonymous donor means that any child that is a result of a sperm from this type of donor or the child’s parents cannot contact the donor. If a donor decides to be an open donor then the child can contact the donor through the sperm bank when the child has reached the age of 18 (Nordic cryobank, n.d.). Now that the processes of sperm donation have been
27 presented, the next chapter will further discuss the experiences of sperm donors and how they perceive themselves shedding further light on the subject of sperm donation.
2.3 Masculinity and sperm donors Sebastian Mohr (2014) did his ethnographic research on sperm donors in Denmark. He used the sperm donors’ narratives to try and understand and explore why men donate their sperm. Mohr argues that men embody masculinity as they engage in the many different dimensions of sperm donation (Mohr, 2014, p. 162).
In Mohr’s interviews with sperm donors he noticed how the donors described their good semen quality as well as the practice of preventing ejaculation 48 hours prior to the donation was considered and portrayed as a lust-centered, sexual experience. The wait for showing up for sperm donation was something that most men mentioned as an exciting sexual practice. Many men considered it a boost or a motivation since they weren’t allowed to masturbate until they got to the sperm bank. According to Mohr (2014, p. 169) many of the men seemed to be proud of the control they had in their sexual practices, mostly in masturbation. Mohr says that through this sort of biomedicine, the sperm donors appropriate their masculine self-image. That is mostly through the measurements of sperm cell quality and count. One of the men in his interviews stated this:
...When I am talking with someone who says something annoying or irritating, then you can look at them once and say [to yourself]: He has probably just 10 million sperm cells or just 5 million. And then you can say [to yourself]: I have without doubt sperm quality ten times better than yours. I can be the father of your children because you are not able to impregnate your wife… (Mohr, 2014, p.169).
The statement by the sperm donor shows how he embodies masculinity through the sperm count and situates himself higher in hegemonic masculinities. He seems to believe that another man's lack of potency in impregnating women is an indication of a lesser man and that his sperm count and quality makes him more of a man (2014, p. 170).
28 The sperm donors in Mohr’s research talked about how donating sperm was also a moral obligation. They felt as if they were doing something good and influencing the world we live in, providing childless couples a chance to become parents. One participant talked about how he lost his parents a few years back and by being a sperm donor he felt that he was giving his parents grandchildren, which had been their dream. Some men also mentioned that they felt as if they were being good husbands and fathers by donating their sperm. That somehow fulfilled their moral obligations towards the community and as their role as providers. Many of the sperm donors mentioned that to begin with it they did it for the money but that often changed later on when they had been donors for some time into other reasons such as moral obligation, sexual excitement and so on (2014, p. 167).
It also seems as if sperm donors are not shy about donating sperm. Donating sperm is something that they are proud of and some of the sperm donors discussed about how they even occasionally use it to hookup with women. One of the sperm donors voiced his worries that women he hooked up with would try and use his good quality sperm and that his sperm was something that was sought after by women. Having the feeling of pride in good sperm quality was mentioned by most of the men participating in Mohr’s (2014, p. 169) research.
Relating these accounts and descriptions from the sperm donors to the concept of hegemonic masculinity, it is possible to see how the perceptions of masculinity can be found in the men’s ideas of good sperm quality and count. This perception of masculinity in sperm donors is apparent in the next chapter where strong Viking masculinity is associated with desirable sperm.
2.4 The Viking sperm When examining the websites of the largest sperm donor banks it is noticeable that the pictures of the sperm donors the websites had uploaded were all quite similar (Nordic Cryo Bank, n.d.; European Sperm Bank, 2017b). The websites were aiming to encourage men to sign up as sperm donors and a common way to do that was by using pictures of sperm donors along with a little text about why these men decided to become donors. On the website of one of the largest sperm donor bank in Europe it is possible to find several of these types of advertisements (Nordic Cryo Bank, n.d.). There were for
29 example pictures of smiling young men with texts below the pictures. These texts often contained sentences such as ‘’I can make a dream come true’’ or ‘‘changing the lives of others’’ (Nordic Cryo Bank, n.d.).
What is especially noticeable on for example the Nordic Cryo Bank website was that all the pictures of sperm donors were of young, white men who are presumably heterosexual and of course reproductive (Nordic Cryo Bank, n.d.). This is a type of hegemonic masculinity that Lisa Jean Moore (2002) talks about in context with sperm donation. She discusses how reproductive men are situated above men with infertility. Moore (2002) discusses that the advertising for in vitro fertilization for infertile men is very often similar to advertises used for Viagra. Usually with some type of messages about how infertile men can feel like ‘real’ men again with the help of fertilization procedures. Research shows that men with low semen count often show signs of psychological issues such as depression, despair, and humiliation. According to Moore (2002, p. 113) masculinity is therefore threatened with lower sperm count.
Adrian (2010) examined a website from a Danish sperm bank called the Viking Bank. On that website the donors were given fictional names such as Leif and Thor. People from all over the world can therefore pick a sperm from a ‘Viking donor’. These fictional names were in a way ascribing the donor with a specific masculinity. That is that they are Viking-like, strong, blonde, white, young and healthy. Adrian (2010) also discusses how this reference to the time of the Vikings is connected to the spreading of genes. That is that in the Viking era, men would spread their genes by robbing and raping and how today, spreading these Viking genes is done through sperm donation.
This prominent idea of the sperm donor being a white Viking can be related to ideas of pureness and whiteness, which can be found within sperm banks. For example donor semen is often put into categories based on the donor's race. In one sperm bank there was a color code used on the caps of the specimen cups to imply if the semen came from a white man, black man, Asian man, that is to say they used white caps for semen from white men, yellow caps for semen from Asian men and so on (Quiroga, 2007, p. 150). Seline S. Quiroga (2007) argues that sperm banks aim is not just to create families but specific kind of families and in most cases that is the white nuclear family (Quiroga, 2007).
30 Charlotte Kroløkke (2009) further identifies this idea of whiteness within sperm banks. Kroløkke carried out her research on Cryos International, which is one of the largest sperm banks in the world. She discusses how Cryos International markets their sperm as Viking sperm. Their website has quotes such as ‘’congratulations, it’s a Viking!’’ Kroløkke (2009) claims that the company is marketing their sperm as good quality due to the fact that most of the donors are Scandinavian, white men (2009, p. 13). Therefore they pursue a stereotypical image of Scandinavian men as healthy, white, strong, masculine, moral and smart. The Viking donor qualities are seen as desirable qualities that people should want in their future child. What is also noticeable in the Cryos International sperm bank is that the Viking sperm is made masculine and even given a masculine personality. This is an interesting aspect since statistically, half of the offspring’s of the Viking semen might be female (Kroløkke, 2009).
Relating this idea of the Viking-like men to the theory of the body by Scheper- Hughes and Lock (1987) one can see how the requirements for becoming a sperm donor are similar to the ideas of the politically correct body in our society. The politically correct body in that sense is a body that is strong, healthy and beautiful but also operates well. For example there is a value placed on fertility and endurance (Scheper- Hughes & Lock, 1987, p. 25). The sperm donor’s body goes through surveillance regularly to see if the body remains in a healthy and correct state and therefore it is possible to see how a certain type of body is being socially produced (Scheper-Hughes & Lock, 1987, p. 8).
31 3 Male infertility Male partners contribute to approximately half of infertility cases (Jose-Miller, Boyden & Frey, 2007, p. 849). There can be several reasons for infertility in men. For example the causes for infertility in men can be either genetic or environmental as well as acquired or of congenital origin. In general, infertility means that a couple cannot conceive even though they have regular unprotected sex. Infertility is usually considered a problem if a couple has been trying to conceive for over a year. If it is suspected that there is a male factor infertility the male partner undergoes evaluation at a clinic or a hospital. The most common conditions in male infertility are impaired sperm quality or quantity, sperm transportation failure and so on. Half of infertility problems in men are due to unknown factors and therefore it can be difficult to treat (Jose-Miller et al., 2007)
Studies have shown that infertility in men is a deeply hidden problem in societies that are rarely discussed in public domains (cited in Inhorn, 2004, p. 162-163). The aim of the following chapters is therefore to shine light on why male infertility is a stigmatized health issue and how infertile men perceive themselves in relation to masculinity.
3.1 Medicalization and male infertility Conrad (2007) discusses how medicalization of aberration and other life events have occurred in the past decades. Medicalization is when a bodily condition, behavior, psychic state etc. become a medical problem or illness that require a medical diagnosis and/or a medical treatment (Conrad, 2007, p. 3). Infertility is for example one of the conditions that has been medicalized in the past decades. Conrad (2007) explains the reasons for why medicalization has increased and why there has been a focus on creating new medical categories. To begin with there are social factors that play a large role in this medicalization for example in western societies, the impact of religion has decreased and faith in science has increased. There has also been a stronger demand towards finding solutions regarding problems in the field of health and wellness (Conrad, 2007, p. 8).
Even though infertility has become a medicalized problem it has mostly focused on female infertility. The male body has been quite absent in terms of reproduction
32 problems or problems related to sexuality or performance. This would seem to be a recurrent subject, that is the absence of the male body, as can been seen in the chapter male body where there is a clear lack of the discussion about the male body both in the academic world and the general social world.
When Viagra was developed in late 1990s the discussion on men’s sexual dysfunction surfaced and became a medicalized problem. Since then researchers have been focusing more on the medicalization of masculinity, male sexuality and also how these types of health problems shape men’s construction of masculinity (Bell, 2016). Ann V. Bell (2016) argues how infertility has in the past been considered a ‘’woman’s problem’’ despite the fact that half of infertility problems are attributed to men. Because of this, infertility is often linked into a feminized context. For example male infertility problems are often treated in the ‘women’s health center’ which in a way suppresses men’s infertility problems and can diminish their sense of masculinity. Infertility and impotence in men are also often mistakenly linked together and therefore seen as a sort of failed sexuality or failed masculine ability (Bell, 2016). In the next chapter infertility and lack of masculinity will be discussed even further as it is important to see how infertility affects men and their masculine identity and how it differs from women being diagnosed with infertility.
3.2 Infertility and lack of masculinity As mentioned earlier male infertility is one of the most stigmatized of all male health problems (Inhorn, 2004, p. 163). Male infertility is very often linked to impotency or the lack of men’s ability to impregnate women. However male infertility has to do with health problems and not impotency as discussed earlier. These health problems are for example low sperm count, low sperm motility, defects in the sperm morphology and lastly a complete absence of sperm in the ejaculate (Inhorn, 2004, p. 162-163).
Research that was done on men with infertility problems in the UK revealed that men did not share their infertility problems with other men. They also spoke of how they felt as if they weren’t living up to the dominant cultural expectations of men. Not being able to do their biological role as men made many them almost feel as if they weren’t men at all. Knowing about their infertility made a significant impact on what kind of men they perceived themselves to be and how they felt as if they had to
33 reconstruct the embodied notions of themselves as men. What was also noticeable in the interviews with these men was how they described their sperm as ‘weak’, ‘lazy’ and ‘dead’. This can be seen as a gendered description of sperm where the sperm is identified with properties that are not considered ‘masculine’. These descriptions are in contrast to how sperm donors describe their sperm. These descriptions can in a way be associated with hegemonic masculinity due to the fact that the concept of hegemonic masculinities implies that men should be strong, healthy and active (Dolan, Lomas, Ghobara & Hartshorne, 2017).
Tine Tjørnhøj-Thomsen (2005) further discusses how people who are infertile view themselves and their illness. She argues that people with infertility do not view themselves as ill or see their infertility as a disease. They consider that infertility is more of a disability and should be considered that way in the public discourse. In their opinion, infertility is no different than a fractured bone and should therefore receive care in the same way that a fractured bone would be cared for. That is to say that for example public expense should cover the cost of procedures related to infertility. People that participated in his research also discussed how they felt as if their infertility was often considered a luxury problem and not taken seriously by others (Tjørnhøj- Thomsen, 2005, p. 75-76).
Discovering infertility problems has various effects on people’s lives. Many feel as if their own body has betrayed them as well as feeling angry towards the fact that their planned parenthood will not go as they expected. The feeling of not having control over their own body generates a complex state of both guilt and disappointment. The disruption of plans can cause anxiety and other mental health problems. Having children is often considered a natural step towards adult life. Infertile couples therefore often experience the feeling of exclusion. Not being able to participate in this huge step in life when almost everyone surrounding them is having children can have a big affect on people’s social relationships. Infertile men and women also discuss how their sense of relating to others often decreases and a gap forms between them and people with children. They discuss how they feel as if this health problem has caused their lives to pause. They become stuck in the same place while everyone else around them continues their lifecycle. Becoming a parent is often considered a rite of passage in
34 society today and is an important factor in adult life. Infertility therefore affects the identity of those who suffer from it and changes the way they see themselves. For example infertile women often experienced the feeling of not being a ‘real adult’ because of their inability to transition into motherhood (Tjørnhøj-Thomsen, 2005, p. 77).
In society today it is often suggested that motherhood is a fundamental expression of being a woman (Gannon, Glover & Abel, 2004, p. 1170). According to Gannon et al. (2004) that is however not necessarily the case with men and fatherhood in western society. They argue that masculinity and manliness is rather associated with the ability to be able to make a woman pregnant than becoming a father. Therefore, being infertile affects masculinity and identity in a different way than it affects women. Their research on infertile men proved that infertile men often feel as if they lack masculinity as well as feeling as if they do not have physical potential. The infertile men in their researched further stressed that they experienced their infertility as a taboo and being stigmatized. All of these accounts that infertile men experience affect their identity and how they view themselves as men in today's society. It impacts their self-esteem causing distress and other mental health problems (Gannon et al., 2004).
Likewise, Seidler (1989, p. 39) argues that men’s view on sex has a lot to do with performance and conquest. There is a pressure on men to perform and achieve in sex and that affects the male ego profoundly. Seidler believes that in sex man can prove themselves as ‘real men’ and therefore failing in sex is a threat to their masculinity. Relating this core idea of men needing to prove themselves with sex, it is possible to see why not being able to impregnate women can make men feel as if they are not ‘real men’.
As mentioned above Gannon et al. (2004) argue that fatherhood isn’t necessarily related to masculinity but rather the act of being able to impregnate women. This might be the case in Western societies but according to Inhorn (2004) it is not the case in the Middle East. In her research Inhorn (2004) studied the consequences of being an infertile man in the Middle East. She stresses that being an infertile man in the Middle East can be incredibly problematic due to the importance of paternity in societies in these countries. Becoming a father is considered an achievement and a big sector in
35 masculine identity in the Middle East. The inability to produce an offspring can therefore have a huge impact on men’s social identities. Inhorn (2004) discusses how it is expected of men and women in Middle Eastern communities to have children and that can be seen in for example the high fertility rates across these countries. Patrilineal structures also play a large role for men in achieving social power. Inhorn (2004) states that being an infertile man in this region of the world is therefore a very threatening and emasculating condition because of the patrilineal social structure in the Middle East. She discusses how infertile men that participated in her research felt embarrassed over their health problems and wanted to keep this health issue a complete secret, not even telling their closest family members. Some of the men discussed how they wouldn’t be seen as ‘’real men’’ if others would know about their health issues (Inhorn, 2004, p. 169-170).
Keeping health issues a secret can have difficult consequences. For example it can entail that the one suffering often feels isolated and alone. Dealing with suffering in an intra physical way often makes the one suffering feel self-blame, self-loath and so on. Anthropologist Michael Jackson (2010, p. 140) stresses the importance of discussing and talking about one’s experience of suffering. By doing that it becomes much easier to deal with the problem. Sharing one's experience with others with the same issue can ease the pain that the suffering causes as well as it helps people to avoid feeling isolated and self-blame. Jackson (2010, p. 140) argues that no matter what the ‘wound’ is, it is always helpful to be able to connect and talk to fellow sufferers about this ‘wound’ that people have in common rather than being a lone victim (Jackson, 2010, p.140).
Esmée Hanna and Brendan Gough (2015) have stressed another focus point, which is the importance on doing qualitative research on men who experience infertility. They examined qualitative research where male factor infertility was involved and found some core themes from the interviews of the male perspectives and concerns involving infertility. One of the main themes was seeing infertility as a crisis. That is to say that men describe this discovery, as disrupting their future and the trauma that followed the discovery was similar to a trauma a person experiences when losing a loved one. Another theme that was quite prominent in the qualitative researches was the narrative
36 of men having to be strong for their partners and therefore suppress their emotions. Men often chose to hide their emotions and become more of a ‘rock’ for their partner. This incites even further the notions of hegemonic masculinity where men take on a masculine role of not showing emotions even though they are going through a traumatic experience. Another theme was the stigma surrounding male infertility. This stigma often relates to the compromising of masculinity that men experienced as well as the language surrounding male infertility such as ‘shooting blanks’ that further causes stigma. It seems as if there is a certain linkage between men not wanting to discuss the health issue due to it being stigmatized and the health issue being stigmatized due to men not discussing it. When a health issue becomes stigmatized it makes the problem even worse for those involved as it becomes harder to discuss and open oneself up about (Hanna & Gough, 2015).
37 4 Discussions As has been discussed in this thesis, sperm donation and infertility is a complex and intricate subject. There are multiple sides ranging from sperm donors seeing themselves as more men than others to infertile men hiding their health issue due to stigma. This comes back to the purpose of this thesis, which is to shine light on the differences between how sperm donors and infertile men perceive themselves.
From the first chapter of this thesis, the gender theory chapter several theories are presented. These theories can be found again in the two chapters that follow, sperm donation and male infertility. One such example is the concept of hegemonic masculinities, which can clearly be seen over and over in the discussion of how men view themselves in relation to sperm. What can be seen from the sperm donors is that they are healthy, heterosexual and commonly white men that in a way live up to the normative standards of hegemonic masculinity. They also use their bodies to represent a particular masculinity that for example disabled men or men with physical limitations cannot (Connell & Messerschmidt, 2005, p. 851). This is in complete contrast to infertile men as they view themselves as lesser men or not even ‘real’ men due to their physical limitation of being able to impregnate women. As discussed earlier in the chapter on anthropology and masculinities, there is often a certain behavior that masculinity is identified with and the characteristics of this behavior is for example that men should hide their emotions, be strong and in control (Seidler, 1989, p.18). Similarly, Johansen (2008, p.19) argues that impotency in men is seen as not having control and that is a central aspect in masculinity. As infertile men are often mistakenly viewed as being impotent one can see how they perceive themselves as lesser men and therefore not living up to the standard ideas of masculinity. The behavior of hiding their emotions also seems to be collective characteristic of the infertile men. As discussed earlier they tend to hide their health problem and even take on the masculine role of being strong for their partner and therefore not showing emotions.
Of course all of this leads to the question of why a cell in the body can affect men’s identities. I believe that it has a lot to do with the discourse on sperm in the social and scientific world as well as how men’s bodies have become more visible and apparent in everyday life. It seems as if the idea of sperm being linked to masculinity is deeply
38 rooted in both societies as well as the medical world. Seeing for instance the usage of military language such as ‘assault’ or ‘attack’ when describing sperm as well as applying stereotypical ideas to the sperm it is comprehensible why it affects men who either have good quality/count or the opposite, having problems with the sperm such as low count, the absence of sperm cells and so on. It is likely that the representation of sperm in the social and scientific world creates the idea that men should be healthy, able, active and potent. It is especially interesting to see the presentation of Viking sperm in the sperm banks. Looking the racial aspect in sperm banks one can see how it seems desirable that the sperm donors are white, with blue eyes and therefore resulting in having white Viking babies. These characteristics all relate to hegemonic masculinity. I believe that this can create a subordinate position for men who suffer from infertility and a dominant position for men who have healthy, active sperm for example sperm donors.
39 5 Conclusions Throughout history anthropologists have dealt with definitions and concepts of gender and sex. The cross-cultural data that anthropologists collected provided feminists the content to establish that gender was socially constructed and not biologically determined. From there on, various ideas of masculinity and femininity emerged. For example in western cultures male sexuality has often been portrayed as aggressive, powerful and thrusting whereas female sexuality is seen as passive, submissive and receptive. Even though anthropology has been considered a masculine field the male gender hasn’t been paid much attention too until recently. Several theories in the subject of masculinity have been mentioned but there is however one theory that has gained immense popularity and that is the theory of hegemonic masculinity. The concept of hegemonic masculinities implies that there is both hierarchy between men and women where women are subordinate, as well as between men and men. For example men are subordinate to other men due to race, social class, ethnicity, sexual orientation, physical disabilities or limitations and so on.
In this thesis, sperm donation has been presented using the concept of hegemonic masculinities. It seems as if becoming a sperm donor places a man higher in the hierarchy of hegemonic masculinities in societies today. Being a healthy, young man with a high sperm count and good sperm quality is something to be proud of and talk openly about. This is something that is quite visible in the advertisements on the sperm bank websites where the men are portrayed as happy, healthy and proud of their act. Reproductive men are in a way situated above infertile men in relation to masculinity and that is especially evident when it comes to the secrecy and stigmatization of male infertility. Male infertility is a relatively common problem but at the same time the most stigmatized of all male health problems. Infertile men often experience anxiety, embarrassment and distress due to this stigma. Male infertility is often linked to impotence or not being in control of one’s own body and this can further result in men seeing themselves as lesser men and therefore not reaching the masculine expectations that the standards of hegemonic masculinities imply.
I believe that comparing how sperm donors perceive themselves and how they express their masculine identity to infertile men and how they express their lack of
40 masculinity can be a very informative way of understanding masculinity in society today. However after looking into the researches done by anthropologists and other scholars it seems as if there is insufficient amount of attention brought to this matters. A possible explanation for this might be the fact that for example studying men as gendered persons as well as men’s bodies has been quite absent in both the academic world as well as the medical world. Male infertility is for example a recently medicalized health problem and this can bring about the lack of research on the subject. This would therefore be an interesting subject to be further researched.
It is my view that anthropologists should open up this discussion and dive deeper into these types of matters that are considered sensitive or private. By doing so they can assist in revealing the stigma that surrounds the subject of male infertility and hopefully reduce it.
41 References
Adrian, S.W. (2010). Sperm stories: Policies and practices of sperm banking in Denmark and Sweden. European Journal of Women’s Studies, 17(4), 393- 411. DOI: https://doi.org/10.1177/1350506810378078
Behar, R. (1995). Introduction: Out of exile. In Behar, R., & Gordon, D. (Eds.), Women writing culture (1-29). Berkeley: University of California.
Bell, A.V. (2016). I don’t consider a cup performance; I consider it a test: masculinity and the medicalisation of infertility. Sociology of Health & Illness, 38(5), 706-720.
Carrigan, T., Connell, B., & Lee, J. (1985). Towards a new sociology of masculinity. Theory and society, 14, 551-604. Retrieved from http://www.jstor.org/stable/657315
Connell, C. (2010). Doing, undoing, or redoing gender: Learning from the Workplace Experiences of Trans People. Gender & Society 24(1), 31-55.
Connell, R.W. (1995). Masculinities. Second edition (2006 reprinted). Polity press: Cambridge.
Conrad, P. (2007). The Medicalization of society: On the transformation of human conditions into treatable disorders. Baltimore: Johns Hopkins University Press.
Corbin, J.M. (2003). The body in health and illness. Qualitative Health Research, 13(2), 256-267. Doi: 10.1177/1049732302239603
Cornwall, A., & Lindisfarne, N. (Eds.). (1994). Dislocating masculinity: comparative ethnographies. London: Routledge.
Csordas, T.J. (1999). The body’s career in anthropology. In H.L. Moore & T. Sanders (Eds.). Anthropology in theory. Issues in epistemology. 336-352. Malden: Blackwell Publishing.
Daniels, K.R. (2000). To give or sell human gametes: the interplay between pragmatics, policy and ethics. Journal of Medical Ethics, 26(3), 206-211.
Dolan, A., Lomas, T., Ghobara, T. & Hartshorne, G. (2017). It’s like taking a bit of masculinity away from you: Towards a theoretical understanding of men’s experiences of infertility. Sociology of Health & Illness, 1-15. DOI: 10.1111/1467- 9566.12548
Dragusin, D. (2014). Metaphorical gender stereotypes in written medical discourse. Journal of Research in Gender Studies, 4(1), 1224-1235.
European Sperm Bank. (2017a). You Cannot Be A Sperm Donor IF… Retrieved from https://www.en.blivsaeddonor.dk/faq/you-cannot-be-a-sperm-donor/ -
42
European Sperm Bank. (2017b). Why Donate Sperm? Retrieved from https://www.en.blivsaeddonor.dk
Gannon, K., Glover, L., & Abel, P. (2004). Masculinity, infertility, stigma and media reports. Social Science & Medicine, 59(6), 1169-1175. DOI: https://doi.org/10.1016/j.socscimed.2004.01.015
Gerschick, T.J., & Miller, A.S. (1997). Gender identity at the crossroads of masculinity and physical disability. In Gergen, M.M. & Davis, S.N. (Eds.), Toward a New Psychology of Gender (455 - 478). London: Routledge.
Gutmann, M.C. (1997). Trafficking in men: the anthropology of masculinity. Annual review of Anthropology, 26, 385-409.
Hanna, E., & Gough, B. (2015). Experiencing male infertility: A review of the qualitative research literature. Sage Open, 5(4), 1-9. Doi: 10.1177/2158244015610319
Inhorn, M. C. (2004). Middle Eastern masculinities in the age of new reproductive technologies: Male infertility and stigma in Egypt and Lebanon. Medical Anthropology Quarterly, 18(2), 162-182.
Jackson, M. (2010). Myths/histories/plots. In Good, B.J., Fischer, M.M. J., Willen, S.S., & Good, M-J.D. (Eds.) A Reader in Medical Anthropology (137-142). Oxford: Wiley- Blackwell Publishing.
Johanson, T. (2008). The full monty: masculinity undressed. Nordic Journal of Masculinity Studies, 3(1), 13-30.
Jose-Miller, A.B., Boyden, J.W., & Frey, K.A. (2007). Infertility. American Family Physician, 75(6), 849-856. Retrieved from http://www.aafp.org/afp/2007/0315/p849.html
Kroløkke, C. (2009). Click a donor: Viking masculinity on the line. Journal of Consumer Culture, 9(1), 7-30. Doi: 10.1177/1469540508099701]
Lock, M. (1993). Cultivating the body: Anthropology and epistemologies of bodily practice and knowledge. Annual review of Anthropology, 221(1), 133-155. Retrieved from http://web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=1&sid=e73b40be- ddee-4fa1-a523-c4c66bab9694%40sessionmgr4006
Martin, E. (1991). The egg and the sperm: How science has constructed a romance based on stereotypical male-female roles. Signs, 16(3), 485-501.
Mascia-Lees, F.E., & Black, N.N. (2000). Gender and anthropology. Illinois: Waveland Press.
43 Mcllvenny, P. (2003). Disabling men: masculinity and disability in Al Davidson’s graphic autobiography the spiral cage. In Ervø, S., & Johansson, T. (Eds.)Bending Bodies: moulding masculinities, volume 2. (238-259). England: Ashgate Publishing.
Mohr, S. (2014). Beyond motivation: on what it means to be a sperm donor in Denmark. Anthropology & Medicine, 21(2), 162-173. DOI: http://dx.doi.org/10.1080/13648470.2014.914806
Moore, H.L. (1994). A passion for difference. Cambridge: Polity Press.
Moore, H.L. & Sanders, T. (1999). Anthropology and epistemology. In H.L. Moore & T. Sanders (Eds.). Anthropology in theory. Issues in epistemology. 1-21. Malden: Blackwell Publishing.
Moore, L.J. (2002) Extracting men from semen: Masculinity in scientific representations of sperm. Social Text, 20(4), 91-119. DOI: 10.1215/01642472-20-4_73-91
Nordic Cryo Bank (n.d.). Become a sperm donor [webpage]. Retrieved from https://www.nordiccryobank.com/
Ortner, S.B. (1972). Is female to male as nature is to culture? Feminist studies, 1(2). 5- 31. Doi: 10.2307/3177638
Petersen, A. (2003). Research on men and masculinities: some implications of recent theory for future work. Men and Masculinities, 6(1), 54-69. Doi: 10.1177/1097184X02250843
Quiroga, S.S. (2007). Blood is thicker than water: Policing donor insemination and the reproduction of whiteness. Hypatia, 22(2), 143-161. Doi: 10.1111/j.1527- 2001.2007.tb00986.x
Scheper-Hughes, N., & Lock, M.M. (1987). The mindful body: A prolegomenon to future work in medical anthropology. Medical Anthropology Quarterly, 1(1), 6-41.
Seidler, V.J. (1989). Rediscovering masculinity: reason, language and sexuality. London: Routledge.
Seidler, V.J. (2003). Men, bodies and identites. In Ervø, S., & Johansson, T. (Eds.) Bending Bodies: moulding masculinities, volume 2. (77-92). England: Ashgate Publishing.
Tjørnhøj-Thomsen, T. (2005) Close encounters with infertility and procreative technology. In Jenkins, R., Jessen, H., and Steffen, V. (Editors), Managing Uncertainty (71-91). Copenhagen: Museum Tusculanum Press.
Van Den Broeck, U., Vandermeeren, M., Vanderschueren, D., Enzlin, P., Demyttenaere, K. & D’Hooghe, T. (2013). A systematic review of sperm donors: demographic characteristics, attitudes, motives and experiences of the process of sperm donation. Human Reproduction Update, 19(1), 37-51.
44 Wagner, W., Elejabarrieta, F., & Lahnsteiner, I. (1995). How the sperm dominates the ovum: objectification by metaphor in the social representation of conception. European Journal of Social Psychology, 25, 671-688. Retrieved from http://www.swp.jku.at/drupal/files/files/wagner_wolfgang/wagneretal_ejsp_1995x. pdf
West, C., & Zimmerman, D.H. (1987). Doing gender. In Kimmel, M. & Aronson, A (Eds.), The gendered society reader (200-213). New York: Oxford University Press. Butler, J. (1988). Performative acts and gender constitution: An essay in phenomenology and feminist theory. Theatre Journal, 40(4), 519-531. Doi: 10.2307/3207893
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Ágústa Hrönn Hjartardóttir
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